[논문]뇌혈류초음파검사에서의 주의사항 및 제안

강건우; 이의정; 이현경; 이은선; 임양희; 한형태

doi:10.15324/kjcls.2023.55.3.219

뇌혈류초음파검사에서의 주의사항 및 제안
Precautions and Suggestions for Transcranial Doppler Ultrasonography 원문보기

Korean journal of clinical laboratory science : KJCLS = 대한임상검사과학회지, v.55 no.3, 2023년, pp.219 - 226

강건우 (삼성서울병원 신경검사실) , 이의정 (삼성서울병원 신경검사실) , 이현경 (삼성서울병원 신경검사실) , 이은선 (삼성서울병원 신경검사실) , 임양희 (삼성서울병원 신경검사실) , 한형태 (삼성서울병원 신경검사실)

초록
AI-Helper

뇌혈류초음파(TCD) 검사는 일반적으로 2 MHz의 낮은 주파수를 이용해서 두개강 내의 혈류속도 및 파형을 측정하는 검사이다. 많은 병원에서 병리사들이 검사를 시행하고 있고 학교, 뿐만 아니라 학회차원에서 교육들도 이루어지고 있다. 하지만 TCD검사는 검사자의 스킬이 무엇보다 중요한 검사 중에 하나다. 처음으로 검사를 접하는 검사자들은 혈관이 잘 찾아지지 않아 고민이 생기고, 어느 정도 경험한 검사자들은 혈관이 너무 많이 찾아져서 고민이 된다고 한다. 직접 혈관을 보고 측정하는 검사가 아니기 때문에 많은 제한과 어려움이 있을 수밖에 없다. 그래서 TCD 검사자들을 위해서 검사를 시행할 때 주의사항과 노하우를 소개함으로써 도움을 드리고자 한다.

Abstract ▼ AI-Helper

Transcranial doppler ultrasonography (TCD) applies a low frequency of 2 MHz to measure the blood flow velocity and waveform within the skull. Medical technologists at several hospitals are conducting these examinations, and education is being imparted in many schools and academic societies. However, the skill of the tester is of utmost importance when performing TCD. Technicians who are conducting the procedure for the first time have trouble locating the blood vessels, and some experienced personnel are worried because too many blood vessels are present. Since this procedure does not directly look at and measure blood vessels, there are several limitations and difficulties. Therefore, this study aims to provide some help by introducing precautions and suggestions for TCD technicians conducting the test.

주제어

표/그림 (8)

그림 Figure 1. Angle (It is important to keep the error less than 15% by minimizing theta [θ] to less than 30 degrees, and clinically meaningful values can be obtained up to an incident angle of 60 degrees).
그림 Figure 2. Anatomic variants. Abbreviations: ACoA, anterior communicating artery; PCoA, posterior communicating artery; ACA, A1, anterior cerebral artery (A1 portion); PCA, P1, posterior cerebral artery (P1 portion).
표 Table 1. Reference value
표 Table 2. Attenuation coefficient for various tissues
그림 Figure 3. Sample volume. (A) When measured with a sample volume of 10 mm, the average blood flow rate was measured as 83 cm/sec at a depth of 60 mm. (B) When measured with a sample volume of 15 mm, the average blood flow rate at a depth of 60 mm is 114 cm/sec, which may be overlapped with other blood vessels or overlapped with a depth of 54 mm. Abbreviations: MCA, middle cerebral artery; L, left; PW, pulse wave.
그림 Figure 4. Orbital window. (A) Properly measuring OA and siphon, (B) misadjusting the angle and depth can result in an error measuring ACA instead of siphon. Abbreviations: OA, ophthalmic artery; ACA, anterior cerebral artery; Lt., left; Rt., right.
그림 Figure 5. Subareas of temporal window. Abbreviations: F, frontal; A, anterior; M, middle; P, posterior.
그림 Figure 6. VA caution. (A) It is possible to make an error in measuring the contralateral VA. (B) Errors can be reduced if the probe is examined after moving in the same direction as the biased direction. (C) Blood vessels biased to one side in magnetic resonance angiography. Abbreviations: VA, vertebral artery; BA, basilar artery; Lt., left; Rt., right.

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